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(extended-release tablets, often available as generics or branded equivalents like ConZip or Ultram ER) is a long-acting prescription opioid analgesic indicated for the management of moderate to moderately severe chronic pain in adults requiring continuous, around-the-clock treatment when alternative non-opioid therapies are inadequate. The 200mg extended-release formulation provides sustained pain relief over approximately 24 hours through its dual mechanism of action: weak mu-opioid receptor agonism to directly reduce pain perception, plus inhibition of serotonin and norepinephrine reuptake to enhance descending pain modulation. This higher-strength ER tablet is typically reserved for patients who have demonstrated tolerability to lower immediate-release or extended-release doses and need consistent, once-daily dosing for conditions such as chronic musculoskeletal pain, neuropathic pain, osteoarthritis, or other persistent pain states where steady control improves daily function and quality of life.

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Important Safety Information Tramadol 200mg ER is a Schedule IV controlled substance with risks of addiction, abuse, misuse, and physical dependence. It carries boxed warnings for life-threatening respiratory depression (risk heightened at higher doses like 200mg, during initiation or dose increases, in elderly patients, or when combined with alcohol, benzodiazepines, other opioids, or CNS depressants), serotonin syndrome (especially with SSRIs, SNRIs, MAOIs, triptans, or other serotonergic agents), seizures (dose-related, increased risk with history of seizures or concurrent use of seizure-threshold-lowering drugs), and neonatal opioid withdrawal syndrome (if used during pregnancy). Do not crush, chew, dissolve, or split extended-release tablets—this can cause rapid release of tramadol, leading to overdose and death. Common side effects include nausea, dizziness, constipation, headache, somnolence, dry mouth, and sweating. Use only as prescribed by a licensed healthcare provider, for the shortest duration necessary, and under close medical supervision. Avoid alcohol completely. Patients with respiratory impairment, hepatic/renal dysfunction, seizure disorders, or history of substance use require extra caution. In the event of overdose symptoms (slow/shallow breathing, extreme drowsiness, seizures, coma), seek emergency medical help immediately—naloxone may reverse opioid effects but may not fully address serotonin or seizure complications.

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Always adhere strictly to your prescribing physician’s instructions and consult them before starting, adjusting, or discontinuing any opioid medication.


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